Inconsistency in classification and reporting of in-hospital falls.

Objectives: To investigate agreement between hospital staff on what constitutes a fall and should be recorded on an incident report, to identify factors that influence whether a scenario is classified as a fall, and to examine the effect of providing a definition of a fall on interrater agreement.

Design: Two interrater agreement trials with pre-postintervention design.

Setting: Seven hospitals.

Profiling early outcomes during the transition from hospital to home after brain injury.

Primary Objective: To profile early outcomes during the transition from hospital to home for individuals with acquired brain injury (ABI) and their family caregivers.

Research Design: Prospective longitudinal study with data collected at three time points: pre-discharge and 1- and 3-months post-discharge.

Methods And Procedures: Participants included 26 individuals with ABI and 26 family caregivers, who were assessed on measures of global functioning, psychosocial reintegration, health-related quality-of-life and emotional well-being.

Documentation of in-hospital falls on incident reports: qualitative investigation of an imperfect process.

Background: Incident reporting is the prevailing approach to gathering data on accidental falls in hospitals for both research and quality assurance purposes, though is of questionable quality as staff time pressures, perception of blame and other factors are thought to contribute to under-reporting.

Methods: This research aimed to identify contextual factors influencing recording of in-hospital falls on incident reports. A qualitative multi-centre investigation using an open written response questionnaire was undertaken.

Alpha4beta1 integrin blockade after spinal cord injury decreases damage and improves neurological function.

The extent of disability caused by spinal cord injury (SCI) relates to secondary tissue destruction arising partly from an intraspinal influx of neutrophils and monocyte/macrophages after the initial injury. The integrin alpha4beta1, expressed by these leukocytes, is a key to their activation and migration into/within tissue. Therefore, blocking this integrin's functions may afford significant neuroprotection.

Bus use and older people: a literature review applying the Person-Environment-Occupation model in macro practice.

The same reasons that prompt older people to give up driving can also result in difficulties with accessing public transport. Difficulties using public transport can limit older people's participation in society, thereby impacting negatively on their health. Focusing on public buses, this review explicates the link between bus usability and the health of older people and frames existing evidence on bus usability issues.

Predictors of prospective memory in adults with traumatic brain injury.

Previous studies have established that prospective memory is commonly affected following traumatic brain injury (TBI). This study examines whether demographic factors, injury severity and site, executive function, and metacognitive factors predict prospective memory performance in adults with TBI, using a cross-sectional multivariate correlational model. Prospective memory of 44 adults (mean age = 30 years) with severe TBI was measured by the Cambridge Prospective Memory Test (CAMPROMPT) time-based and event-based scores.

Risk assessment and management for providers of community-based rehabilitation to people with acquired brain injury: health professionals' perspectives.

Purpose: This study aimed to explore health professionals' perspectives regarding the presence, assessment and management of risks when providing community-based rehabilitation (CBR) to clients with acquired brain injury (ABI).

Method: A qualitative approach using semi-structured interviews of health professionals working in CBR.

Results: The main themes were: (1) risk assessment in CBR settings is an informal, unstructured, complex, multi-phase and cyclical process extending over a period of time; (2) structured and standardised risk assessments were not considered ideal for use in CBR services catering for people with ABI; (3) CBR services face numerous challenges in providing effective risk assessment and management; (4) the risks encountered by health professionals in CBR settings are not always predictable or preventable; and (5) CBR risk management focuses on implementing a range of practical strategies.

Using ICF-Environment factors to enhance the continuum of outpatient ABI rehabilitation: an exploratory study.

Purpose: This study utilized the Environment dimension of the ICF, to explore needs of outpatients and their family members in the context of system and professional needs in an outpatient rehabilitation unit.

Method: A two-phase qualitative exploration comprised structured workshops with outpatient rehabilitation unit professional staff and semi-structured interviews on two occasions with 18 outpatients and their significant others. Data was thematically analysed and categorized according to ICF Environment dimensions.

Self-identified goals and the ability to set realistic goals following acquired brain injury: a classification framework.

Objective: To develop a framework for classifying the nature of goals identified by people with acquired brain injury (ABI) and explore the extent to which goals and the ability to set realistic goals vary over time and according to stage of recovery.

Methods: Participants included 60 people with ABI comprising two subgroups: a post-acute subgroup (n = 28, mean time since injury = 1.1 years, SD = 0.

Evidence-based practice in everyday clinical practice: strategies for change in a tertiary occupational therapy department.

Evidence-based practice is an approach that has gained recognition for facilitating the transfer of evidence into quality clinical practice. While occupational therapy clinicians have a professional responsibility to ensure that their practice is effective, managers also have a responsibility to implement structures and systems that will support therapists in doing so. A review of the literature demonstrated limited evidence of specific organisational models of practice to facilitate the transfer of knowledge into occupational therapy practice.

Comparison of individual, group and combined intervention formats in a randomized controlled trial for facilitating goal attainment and improving psychosocial function following acquired brain injury.

Objective: To compare individual, group and combined intervention formats for improving goal attainment and psychosocial function following acquired brain injury.

Design: Randomized controlled trial, waiting list controls.

Participants: Thirty-five participants with a mean time of 5.

Does Enhanced Primary Care enhance primary care? Policy-induced dilemmas for allied health professionals.

One aim of Medicare's Enhanced Primary Care (EPC) initiative is to encourage multidisciplinary care of patients with chronic disease by funding five allied health treatment sessions per patient per year. In many cases, the number of funded treatments is far less than standard clinical practice indicates, particularly when the five visits are shared between service providers. We believe clinical outcomes may be compromised by adhering to the funded hours, and inequity of outcome may arise based on socioeconomic status and the ability of patients to pay.

A qualitative study of the transition from hospital to home for individuals with acquired brain injury and their family caregivers.

Primary Objective: To explore the transition experiences from hospital to home of a purposive sample of individuals with acquired brain injury (ABI).

Research Design: Phenomenological, qualitative design.

Methods And Procedures: Semi-structured interviews were conducted with 13 individuals with ABI (mean time since discharge = 15.

Participant perspectives on an individualised self-awareness intervention following stroke: a qualitative case study.

Most research investigating the efficacy of neurorehabilitation has focused upon pre- versus post-intervention functioning, which is important for evidence-based practice but overlooks the therapeutic process. Therefore, this qualitative study aimed to investigate a participant's perspective of experiences in therapy throughout an awareness rehabilitation intervention. The participant(CP), a young male with awareness deficits following a right thalamic stroke,had repeatedly attempted to return to work and experienced recurrent periods of depression associated with his employment difficulties.

Reliability and normative data for the comprehensive assessment of prospective memory (CAPM).

The Comprehensive Assessment of Prospective Memory (CAPM) is a questionnaire designed to evaluate frequency of prospective memory (PM) failures in people with brain injury. The aims of this study were to investigate the psychometric properties of the CAPM, including test-retest reliability and internal consistency, and to establish normative data by comparing CAPM scores between groups on the basis of sex, age, and education. Data were collected on 95 people aged 15-60 years living in the community, with no history of brain injury, using the CAPM.

The transition from hospital to home for individuals with acquired brain injury: a literature review and research recommendations.

Purpose: To review the literature relating to the transition from hospital to home for individuals with acquired brain injury (ABI) and make recommendations concerning the future direction of transition-specific research.

Method: Relevant research articles were identified through searching existing database systems and by reviewing the reference lists of identified articles. Only articles in which the results directly related to individuals with ABI from the time of discharge to 1 year post-discharge were included in the review.

Prospective memory in adults with traumatic brain injury: an analysis of perceived reasons for remembering and forgetting.

Reasons for prospective remembering and forgetting after traumatic brain injury (TBI) were investigated using Ellis' (1996) five phases of prospective memory as a framework. Participants were 38 individuals with severe TBI and 34 controls. Participants self-rated their perceived reasons for prospective remembering and forgetting using section C of the Comprehensive Assessment of Prospective Memory (CAPM).

The cellular inflammatory response in human spinal cords after injury.

Spinal cord injury (SCI) provokes an inflammatory response that generates substantial secondary damage within the cord but also may contribute to its repair. Anti-inflammatory treatment of human SCI and its timing must be based on knowledge of the types of cells participating in the inflammatory response, the time after injury when they appear and then decrease in number, and the nature of their actions. Using post-mortem spinal cords, we evaluated the time course and distribution of pathological change, infiltrating neutrophils, monocytes/macrophages and lymphocytes, and microglial activation in injured spinal cords from patients who were 'dead at the scene' or who survived for intervals up to 1 year after SCI.

Objective and behavioural assessment of the emergence from post-traumatic amnesia (PTA).

Primary Objective: To determine the profile of resolution of typical PTA behaviours and describe new learning and improvements in self-care during PTA.

Research Design: Prospective longitudinal study monitoring PTA status, functional learning and behaviours on a daily basis.

Methods And Procedures: Participants were 69 inpatients with traumatic brain injury who were in PTA.

The incidence of visual perceptual impairment in patients with severe traumatic brain injury.

Primary Objectives: To investigate the incidence of visual perceptual impairments in a sample of patients with traumatic brain injury (TBI) using the Occupational Therapy Adult Perceptual Screening Test (OT-APST), compare incidence rates to a normative sample and explore the relationship between the presence of visual perceptual impairment and the severity of cognitive and functional impairment following TBI.

Research Design: Cohort study using a convenience sample of patients with TBI and a normative sample.

Methods And Procedures: Thirty-one patients with severe TBI and 195 healthy people were compared on the OT-APST and measures of cognition and function.

Construct and ecological validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST).

This paper reports on the construct validity (scale design and convergent validity) and ecological validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST). The performance of 208 participants following stroke on the OT-APST and a reference tool (either the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) or the LOTCA-Geriatric version (LOTCA-G)) was compared. The OT-APST performance of the stroke sample was compared with a healthy normative sample (n = 356).

Criterion validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST).

This paper reports on the criterion validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST) including concurrent criterion validity and its sensitivity and specificity. The performance of 208 people following stroke on the OT-APST and a reference tool (either the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) or the LOTCA--Geriatric version (LOTCA-G)) was compared. The OT-APST subscale scores and performance outcome (intact or impaired) on related subscales of the reference tool was analyzed to evaluate the concurrent criterion validity of the OT-APST and its sensitivity and specificity at selected cut-off scores.

Using occupation to facilitate self-awareness in people who have acquired brain injury: a pilot study.

Background: Impaired self-awareness in people who have had an acquired brain injury (ABI) is a complex phenomenon that impedes rehabilitation progress and outcome.

Purpose: This pilot study investigated the effect of an occupation-based intervention program on the self-awareness and emotional status of people after ABI. Four male adults with impaired self-awareness following ABI participated in this study.

Development of a standardized occupational therapy screening tool for visual perception in adults.

Occupational therapy assessment and treatment of visual perceptual impairments are integral to the rehabilitation of clients following stroke and other acquired brain injuries. Occupational therapists need to identify the nature of visual perceptual performance impairments in order to choose rehabilitation intervention strategies appropriate for remediation of specific problems or to compensate for limitations in daily function. This paper describes the variations in visual perception terminology and occupational therapy approaches to visual perceptual assessment.